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NDIS 2025-2026 Pricing Arrangements and Price Limits
The 2025-2026 Pricing Arrangements and Price Limits is here
The National Disability Insurance Scheme (NDIS) conducts an Annual Pricing Review of all services delivered to participants. The Review of 2024-25 has informed the 2025-26 Pricing Arrangements and Price Limits which will come into effect on 1 July 2025. There are two important points for osteopaths to note.
Cap on provider travel claims
The total claimable amount of labour time for travel has now been capped at 50% of the applicable hourly rate.
Example
An osteopath bills under the ‘Other Professional’ line item in a non-remote area. The billable rate for provider travel is $97.00 per hour of travel, down from $193.99.
The ‘Remote’ and ‘Very Remote’ rates for the ‘Other Professional’ service line item still apply and should be used in the appropriate geographical areas.
Non-labour travel costs
The process for claiming non-labour costs associated with provider travel (e.g. tolls, parking, kilometres travelled) has not changed and can be claimed in addition to the provider travel hourly rate. Claiming these items against a participant plan still requires a service agreement to be in place.
10-minute increments for price limits
All therapy supports delivered are now billed in 10-minute increments. Consultations should be billed at a pro-rated rate of the hourly rate. The new system allows for more flexible service delivery and better control of therapy support budgets for NDIS participants.
What does this mean for osteopaths?
Positively, as osteopathy does not have an individual service line item and is grouped within the ‘Other Professional’ item, the hourly rate has not been affected.
However, osteopaths will be affected by the 50% cap on provider travel. We are concerned about the impact this may cause to vulnerable individuals in rural and remote communities and will be advocating on your behalf for this to be reviewed and for safeguards to be implemented.
The Pricing Arrangements and Price Limits document has useful examples on provider travel and how that might look with the updated price limits. You can read more about the Annual Pricing Review process here, and you can access the 2025-26 Pricing Arrangements and Price Limits documentation here.